We read the comment by Dr. Mormile (1) and thank her for sharing her insight about a potential role of microRNAs (miRNAs) in glucose and skeletal metabolism. Our study did not look into the underlying mechanisms, which are a subject of warranted future research. miR-146a deregulation, besides being linked to bone (2) and potentially to diabetes (3), has also been linked to immune function, hematopoiesis, and cancer, with gene knockout studies indicating a role for this miRNA as a tumor suppressor (4–6). Most of the studies on miR-146a conducted to date with health outcomes are in vitro or in animals, and those few conducted in humans are limited to small studies of very limited sample size, none of them testing associations between miR-146a, diabetes, and risk of fractures (a PubMed search on 21 February 2020 for “miR-146a” [ti] returned 645 hits, whereas the search ((“Clinical Study”[Publication Type] OR “Clinical Studies as Topic” [MeSH] OR “Epidemiology”[MeSH]) AND (“Humans”[MeSH] AND “miR-146a “[ti])) resulted in 12 hits). Therefore, there is need for studies in the field of miRNAs, just as there is need for determinants from other -omics layers (i.e., genomics, epigenomics, transcriptomics, proteomics, metabolomics, and metagenomics) to dissect the complexity of the biological processes underlying bone and glucose metabolism. As such, the involvement of miR-146 in these processes remains a hypothesis, with no immediate clinical relevance for the management of patients with diabetes and vertebral fractures.

Article Information

Duality of Interest. No potential conflicts of interest relevant to this article were reported.